Headache disorder

Headache is nearly universal symptom with a complex & heterogeneous set of causes. Nearly half of the world’s population has an active headache disorders. Headache is common, with a lifetime prevalence of over 90% of the general population in the United Kingdom (UK). It accounts for 4.4% of consultations in primary care and 30% of neurology outpatient consultations.

The cause or type of most headaches can be determined by a careful history and physical examination. While headaches can be caused by medical conditions, injuries, or infections, they are sometimes not due to a specific disease or other identified medical condition.

Three of these (migraine, tension-type headache and medication-overuse headache) are important in primary care because they are common and responsible for almost all headache-related burden.

Patients who present with a pattern of recurrent episodes of severe disabling headache associated with nausea and sensitivity to light, and who have a normal neurological examination, should be considered to have migraine.

Episodic tension-type headache is the most common headache disorder, reported by over 70 % of some populations. Worldwide its 1-year prevalence appears to vary greatly, with an average of 42 % in adults, rather higher in women than in men.

Chronic tension-type headache affects 1 – 3 % of adults. In terms of prevalence, medication-overuse headache far out-weighs all other secondary headaches. This iatrogenic disorder affects more than 1% of some populations, women more than men and some children also.
Headache disorder